How Increased Productivity Might Pave the Way to Personalized Medicine

Software can do amazing things. Take, for example, a couple software packages unveiled at RSNA 2015. One, called GoBrain, can put together a brain in multiple orientations and at varying contrasts in just five minutes. The other, called Simultaneous Multi-Slice (SMS), can reduce the time to do an magnetic resonance (MR) scan by simultaneously exciting and recording multiple slices.

Both are from Siemens Healthcare, which over the years has built a reputation for technologies that increase productivity. But Siemens is not alone.

At RSNA 2015, Philips Healthcare unveiled its latest version of modified Dixon, a software solution for accelerating MR scans. Similarly the company highlighted an approach called ScanWise for managing patients with MR implants that can impose artifacts in images.

Virtually all makers of imaging equipment are working in this space. And, just as Siemens and Philips are not the only companies that recognize the need to do things faster, MR is not the only modality for which such technologies are being developed. At the meeting, Philips introduced “Magic Glass” for its spectral computed tomography (CT). When triggered, this technology opens a window on the display screen to display a spectral image amid conventional CTs.

The simple goal is to allow faster, quicker exams. But much more is going on. It is partly a recognition that ongoing change is being prompted by dwindling resources. Yet it is, ironically, not a harsher, more Spartan future that lies ahead but one that may better serve the interests of the patient. 

Certainly the development of productivity technologies exemplifies the kind of catalysis that is all but inevitable as medicine transitions from volume- to value-based medicine.  But it is not the kind of acceleration that tears at the fabric of medicine but one that weaves it together, makes patient management more effective, more patient centric. It is one in which information and imaging technologies come together, as technologies for one are leveraged by the other.

Algorithms that identify the signs of disease, particularly life-threatening ones, are being developed with the ultimate goal of making medicine more efficient and effective. They may soon prioritize the reading of images, performing a kind of radiological triage that bumps the images that need reading the most to the top the list, resulting hopefully in the treatment of patients in the most need. One day they may even guide scanners in the conduct of patient exams, adjusting protocols to acquire data expeditiously without compromising quality or patient safety.

This newfound dedication to speed is driving practitioners toward the holy grail of medicine: the tailoring of diagnostics and therapeutics to the individual.

A couple decades ago it appeared as though sequencing the human genome would be the means by which personalized medicine would be achieved. It sounded good in theory — that an understanding of each person’s genetic makeup would serve as the template for identifying inherent vulnerabilities to disease and natural barriers against effective treatment. Through this, diagnostic procedures could be forecast and therapy exactly prescribed.

But this theory was based on the belief that time was infinite, when in fact it is the one resource that is most limited. There is never enough time to do what needs to be done. This is especially so as the number of diagnostic tests expand, as spurred by genomics.

Making radiology more efficient and reducing the cost of exams, while making those exams more effective through their intelligent application, may provide the time and money needed to take better care of patients. And, just as modalities become more efficient, driven as they are by advanced information technologies, the analytics and data mining techniques for making more of the data being collected promises to uncover better practices. One key area, not surprisingly, is workflow, whereby predictive analytics may provide the means to identify patients who need specific testing to monitor for the occurrence or recurrence of disease.

From this nexus of information and imaging technologies, exemplified by developments that boost the productivity of modalities and others that extend our understanding of what constitutes best practice, may come the true expression of personalized medicine.

Editor’s note: This is the third blog in a series of four by industry consultant Greg Freiherr on MR Balances Speed and Clinical Reach. To read MR is About to Get Faster, Cheaper and More Valuable: It's About Time, click here; to read The Unsettling Evolution of Advanced Visualization, click here.